Sleep Apnoea and Neruomuscular Respiratory Disorders Flashcards
What is obstructive sleep apnoea syndrome characterised by?
- Recurrent episodes of upper airway obstruction leading to apnoea during sleep
- Usually associated with heavy snoring
- Typically unrefreshing sleep
- Daytime somnolence/sleepiness
- Poor daytime concentration
What 3 factors can lead to repeated closure of the upper airway?
- Muscle relaxation
- Narrow pharynx
- Obesity
What doe repeated closure of the upper airway lead to?
- Oxygen desaturation
- Snoring
- Apnoeas and hypopnoeas
What do apnoeas and hypopnoeas lead to?
Frequent micro-arousals
What do frequent micro arousals lead to?
- Daytime hypersomnolence
- Poor concentration
What problems can result from OSAS?
- Impaired quality of life
- Marital disharmony
- Increased risk of RTAs
- Associated with hypertension, increased risk of stroke and probably increased risk of heart disease.
What is the prevalence of OSAS?
- 2% of men
- 1% of women
How is OSAS diagnosed?
-Clinical history and examination
Epworth Questionnaire
-Overnight sleep study
What is measured in polysomnography?
- Oronasal airflow
- Thoracoabdominal movement
- Oximetry
- Body position
- EEG
- Audiovisual recording
- EOG
- EMG
- ECG
What are the categories of desaturation rate?
0-5 normal
5-15 mild
15-30 moderate
>30 severe
How is sleep apnoea treated?
- Identification of exacerbating factors
- Continuous positive airways pressure (CPAP)
- Madibular repositioning splint
How can identification of exacerbating factors help?
- Weight reduction
- Avoidance of alcohol
- Diagnose and treat endocrine disorders
What is the advice on driving?
- Advise not to drive or restrict driving and inform the DVLA of their condition
- Once satisfactorily treated should be allowed to drive
What is the prevalence of narcolepsy?
0.05%
What is narcolepsy associated with?
- Familial
- HLA DRB1*1501
- HLA DQB1*0602
